询问病史 12ca history
You need to get a detailed history including the timing and acuity of ont, exacerbating and alleviating factors and environment triggers to help you confirm a diagnosis or discard other dias /develop a differential diagnosis. Ask your patient whether there is a history of tobacco u, or other toxic and environmental exposures and his occupational history.
General/biographical[,baiəu'ɡræfik,-kəl] data传记,marital婚姻 status, nativity出生, occupation, informant提供消息的人, time of admission and record, chief complaint, history of prent illness, previous health status(well, ordinary or bad), any infectious dias, allergic history, history of trauma or surgery, smoking (about how many years, average how many pieces per day, cead for how many years), alcohol intake(occasional or frequent),spou’s[spaus] 配偶 health status, menorrhea[,menə'ri:ə]月经 (menarche[me'nɑ:ki:, mə-] 初潮 age , cycle lasting for how many days, menstrual cycle, last menstruation period or age of menopau, any menstrual['menstruəl]月经周期 pain or irregular cycle), childbearing or pregnancy( times , natural labor, abortions流产 ,premature[,premə'tjuə, ,pri:-] delivery早产, stillbirths死产, difficult labor, family history (any c
ongenital先天性 dias, father and mother: still alive, illness ,or cau of death, siblings兄弟姐妹 and children)
常用的症状 symptoms
fever
Cough 咳嗽
Sputum (dry, purulent['pjuərjulənt]脓性的, copious['kəupiəs] green sputum大量绿色痰，tenacious[ti'neiʃəs, tə-] yellow sputum 黄粘痰，frothy white sputum白色泡沫痰，rusty sputum 铁锈色痰
wheezing
Dyspnea during exertion[iɡ'zə:ʃən] or at rest 呼吸困难
Orthopnea[ɔ:'θɔpniə] 端坐呼吸
Paroxysmal[,pærək'sizməl] nocturnal[nɔk'tə:nəl] dyspnea 夜间阵发性呼吸困难
Shortness of breath （SOB）
Chest tightness 胸部紧迫感
Exerci intolerance
pleuritic chest pain 胸膜型胸痛
Pharyngalgia[færin'gældʒiə] ; pharyngodynia[,færiŋ'ɡɔdiniə] 咽痛
Hemoptysis 咯血
Bucking 呛咳
Sneeze喷嚏
snore 打鼾
malai [mæ'leiz]不舒服
myalgia[mai'ældʒiə] 肌痛
insomnia [in'sɔmniə] 失眠
hoarness声嘶
dysphonia [dis'fəuniə]发声困难
常见的体征 physical signs
clubbed fingers杵状指 : incread longitudinal [,lɔndʒi'tju:dinəl] and transver横向 curvature ['kə:vətʃə]弯曲 ,loss of concave [ 'kɔnkeiv]凹面的 nail fold angle, bogginess of nail bed and incread soft tissue bulk of distal phalanx ['fælæŋks, 'fei-]趾骨,指骨, drumsti
ck- like
nicotine staining
cyanosis [,saiə'nəusis]发绀:blue discolouration of mucosal membranes and skin ,caud when mean capillary concentration of deoxyhemoglobin [di:,ɔksi'heməu,ɡləubin]去氧血红蛋白 more than 5g/dl, O2 saturation less than 85%,PaO2 less than 8KPa
peripheral [pə'rifərəl]外围的,次要的 cyanosis: cold blue peripheries, e.g. nail beds due to cold exposures
central cyanosis: warm peripheries, blue tongue or lips
hand flap: due to CO2 retention潴留
asterixis 扑翼样震颤
papilloedema 视乳头水肿
chemosis球结膜水肿
enlarged supraclavicula锁骨上的r [klæ'vikjulə] and axillary [æk'siləri]腋窝 lymph nodes
incread respiratory rate
tachycardia 心动过速
pulsus paradoxus: >10 mmHg ↓on inspiration (en in vere asthma)
barrel chest
hyperexpanded, decread expansion
kyphosis [kai'fəusis] 驼背，脊柱后凸
Inspection:
tachypnea [,tækip'ni:ə] 呼吸急促
accessory muscles of respiration[,respə'reiʃən]: sternocleidomastoid['stə:nəu,klaidə'mæstɔid] 胸锁乳突肌muscle, arm support, alae flaring
wide or narrow intercostal[,intə'kɔstəl] 肋间的 space
tactile触觉的 vocal声音的 fremitus震颤 触觉语颤
subcutaneous crepitus 皮下捻发感
Percussion:
resonance清音
dullness浊音
flatness实音
hyperresonance过清音
tympany/timp2ni/鼓音
lower borders: scapular['skæpjulə]肩胛的 line X left/right intercostal[,intə'kɔstəl] 肋间的 space
range of mobility[məu'biləti]移动
Auscultation[,ɔ:skəl'teiʃən]:听诊
vocal resonance 语音共振
ronchi: wheeze , stridor['straidə] 喘鸣 , crackles['krækl]发出细碎的爆裂声, Velcro-like soundes
moist rales : coar粗的, medium中等的, fine好的, crepitus捻发音
pleural friction rubs
complete abnce of breath sounds
ankle edema
weight loss，cachexia[kə'keksiə]恶病质，cachectic[kə'kektik]恶病质的
decread food appetite, loss of appetite, anorexia[,ænə'reksiə]食欲减退
常做的检查 examinations or laboratory findings
(to take ,undergo, perform ,receive or have)
temperature charts 体温图 (take one’s body temperature)
sputum pot 痰盂
Blood/urine/stool routine, occult['ɔkʌlt/ blood test潜隐血试验
Blood biochemistry
Sputum /blood culture and drug nsitivity test
sputum cytology[sai'tɔlədʒi]细胞学
Pul oximeter[ɔk'simitə] 脉氧计：continuous monitoring of blood oxygen saturation
Arterial blood gas analysis(ABG): arterial blood sampling , radial/ femoral['femərəl]股骨的 artery puncture穿刺
PaCO2: partial pressure of carbon dioxide in arterial blood hypercarbia
PaO2: partial pressure of oxygen in arterial blood hypoxemia[,haipɔk'si:miə]血氧不足
respiratory failure:
type 1: decread O2 supply, PaO2＜60 mmHg(millimeters of mercury['mə:kjuri]汞)
due to diffusion failure or V/Q dismatch (ventilation-perfusion(quotient)ratio)
pulmonary edema, pneumonia, infarction, fibrosis,or pulmonary embolism，pulmonary hypertension, shunt
type 2: decread CO2 removal, PaCO2＞50 mmHg(millimeters of mercury)
due to alveolar ventilation failure
obstructive: COPD, asthma, bronchiectasis
restrictive: neuromuscular[,njuərəu'mʌskjulə]神经肌肉 (datives['sɛdətiv]镇静剂 myasthenia[,maiəs'θi:niə]肌无力), structural['strʌktʃərəl]结构的 (ankylosing spondylitis[,æŋki'ləuziŋ,spɔndi'laitis]强直性脊柱炎), pleural dias ,obesity
Chest X-ray/radiograph:
reticulo-nodular shadowing (reticular[ri'tikjulə]网状的, linear['liniə]线状的, military nodules粟粒样结节)
coin lesions 硬币样
cavities空腔：amphoric['æmfərik] 空翁音的(breathing like blowing over a bottle top)
opacification[əu,pæsifi'keiʃən]浑浊：consolidation (air space infiltrate):
confluent['kɔnfluənt]支流的,汇合的 shadowing and air bronchogramf支气管造影
collap: lobar(upper, middle/lingual, lower)
gmental atelactasis肺不张
pleural effusion
mediastinal[,mi:diæs'tainəl]纵隔 mass: thyroid ,thymoma[θai'məumə]胸腺瘤, teratoma[,terə'təumə]畸胎瘤, TB lymph nodes,
terrible diagnos including lymphoma[lim'fəumə]淋巴瘤 and aneurysm动脉瘤
Chest CT scan( computed tomography)
Head MRI(magnetic resonance imaging)
PET-CT of the whole body(positron-emission tomography) ['pɔzitrɔn]正电子
Abdominal ultrasound['ʌltrəsaund]超声
skin prick test 皮肤点刺试验（dust mites尘螨，pollen花粉，cockroach蟑螂）
tuberculin skin test (purified protein derivative[di'rivətiv] 纯蛋白衍生物(of tuberculin) test, PPD test)
Pulmonary function test : Spirometry [spai'rɔmitri]呼吸量测定法，肺量测定法
obstructive lung dias: airflow limitation
FEV1/FVC FVC RV and TLC KCO
< 0.7 ↓ ↑ ↓
restrictive lung dias: decread lung compliance and small lung volumes
intraparenchymal >0.75 ↓↓ ↓ ↓
extraparenchymal variable ↓↓ ↓ normal
FEV1: forced expiratory[iks'paiərətəri/ volume in 1 cond
FVC: force vital capacity
TLC: total lung capacity
RV: residual volume
KCO: transfer factor ( diffusion rate)
PEFR: peak expiratory flow rate
flow-volume loop ( inspiration and expiration[,ekspi'reiʃən])
bronchoprovocation/challenge test[,prɔvə'keiʃən] 支气管激发试验：histamine['histəmmin] 组胺or methacholine乙酰甲胆碱-inhalation[,inhə'leiʃən]
bronchodilatation[,dailə'teiʃən]支气管舒张试验: salbutamol沙丁胺醇[sæl'bju:təmɔ(:)l]
fiberoptic bronchoscopy[brɔŋ'kɔskəpi]: biopsy['bai,ɔpsi]活组织检查 bronchial brush samples for pathological examation, bronchial washings)
bronchoalveolar lavage (BAL)
protected specimen brush (PS
transthoracic[,trænsθə'ræsik,]经胸廓的 percutaneous needle aspiration[,æspə'reiʃən]吸引术
percutanous needle biopsy under CT guidance ( for peripheral tumours)
video-assisted thoracoscopic-guided[θɔ'rækəskəup] 胸腔镜 lung biopsy
open lung biopsy
pleural biopsy
biopsy of enlarged lymph nodes
D-Dimers
electrocardiogram (ECG)心电图
echocardiogram超声心动图
V/Q isotope['aisəutəup] 同位素 scan ( ventilation/perfusion scanning)
spiral螺旋 CT/MRA (Magnetic Resonance Angiography[,ændʒi'ɔɡrəfi]血管造影术)
pulmonary angiography
Doppler['dɔplə] 多普勒 USS thigh[θai]大腿 and pelvis['pelvis] 骨盆 (USS: ultrasound scanning)
cardiac monitor
PSG( polysommography)
常见的病名 dias
acute upper respiratory tract infection 急性上呼吸道感染
common cold 普通感冒
influenza 流感[,influ'enzə]
pharynigitis 咽炎pharyngalgia[færin'gældʒiə] 咽痛
acute broncho-bronchitis 急性气管-支气管炎
pneumonia 肺炎
community acquired pneumonia (CAP) 社区获得性肺炎
hospital acquired pneumonia (HAP) 医院获得性肺炎
nosocomical pneumonia (NP) 医院内肺炎
bronchiectasis 支气管扩张
chornic bronchitis 慢性支气管炎
pulmonary emphyma 肺气肿
chronic obstructive pulmonary dia (acute exacerbating) AECOPD COPD急性发作
bronchial asthma 支气管哮喘
allergic rhinitis[rai'naitis]过敏性鼻炎
respiratory failure 呼吸衰竭
lung abscess 肺脓肿
pulmonary tuberculosis 肺结核病
lung cancer: 肺癌
primary bronchogenic carcinoma 原发性支气管肺癌
squamous['skweiməs] cell carcinoma 鳞癌
adenocarcinoma 腺癌['ædənəu,kɑ:si'nəumə]
bronchoalveolar cell carcinoma 支气管肺泡细胞癌
small cell lung carcinoma （SCLC）小细胞肺癌
pulmonary metastasis 肺转移瘤[mə'tæstəsis]
pulmonary embolism （PE） 肺栓塞
pulmonary thromboembolism (PTE) 肺血栓栓塞症[,θrɔmbəu'embəlizəm]
pulmonary infarction 肺梗死
deep venous thrombosis ,DVT 深静脉血栓形成
empyema 脓胸[,empai'i:mə]
pneumothorax气胸
pyopneumothorax 脓气胸['paiəu,nju:məu'θɔ:ræks]
chronic suppurative dia 慢性化脓性疾病['sʌpjuərətiv, -reitiv]
congenital cyanotic dia 先天性紫绀性心脏病[,saiə'nɔtik]
cor pulmonale 肺源性心脏病['kɔ:,pumə'næli]
pulmonary hypertension 肺动脉高压
pulmonary encephalopathy 肺性脑病[en,fə'lɔpəθi]
right heart failure; right-sided heart failure 右心衰竭
pulmonary vascular dias 肺血管疾病
interstitial lung dia, ILD 弥漫性间质性肺疾病
idiopathic pulmonary fibrosis, IPF 特发性肺纤维化[,idiə'pæθik]
cryptogenic[,kriptəu'dʒenik] 隐源性的 fibrosing alveolitis, CFA 隐源性纤维化性肺泡炎
connective tissue related lung dias 结缔组织相关性肺疾病
systemic lupus['lju:pəs]狼疮 erythematosus, SLE 系统性红斑狼疮
rheumatoid arthritis, RA 类风湿性关节炎
systemic sclerosis, SSc 系统性硬化
scleroderma 硬皮病
sjoren’s syndrome 感知综合征
polymyositis 多发性肌炎
dermatomyositis 皮肌炎
sarcoidosis 结节病[,sɑ:kɔi'dəusis]
Pulmonary alveolar proteinosis[,prəutii'nəusis], PAP 肺泡蛋白沉积症
Idiopathic pulmonary hemosiderosis ['hi:məu,sidə'rəusis, ,hem-]特发性肺含铁血黄素沉着病
